Forceps for medical use

ABSTRACT

Forceps having two-half shells are disclosed. Each half-shell includes a front rim and a base wall and is mounted on a support element in a manner such that the half-shells can adopt a first opened-out configuration and a second closed configuration. The forceps include at least one container element having a cavity for receiving a plurality of biopsy samples. The container element is preferably associated with one of the half-shells.

This application claims priority to International Application No.PCT/IB00/01532, filed Oct. 24, 2000, and Italian Application No.CE99A000004, filed Oct. 25, 1999.

The present invention relates to forceps for medical use, in particularfor biopsy, for example, for endoscopic biopsy, laparoscopy,gynaeocological applications and the like.

More specifically, a conventional forceps of this type comprises twohalf-shells, each of which has a front rim and a base wall, and whichare mounted on a support element in a manner such that they can adopt afirst, opened-out configuration and a second, closed configuration.

In use, for example, during digestive endoscopy, the forceps is passedthrough the operating duct of an endoscope in the closed configurationand is brought into contact with the internal mucosa of the organ (forexample, the oesophagus, stomach, duodenum, or colon) to be biopsied.

Once the forceps has been positioned correctly, the half-shells areopened and then closed so as to cut off a sample of the mucosa whichremains held between them. Given the intrinsically limited nature of thespace available, the closed half-shells can hold at most 2–3 biopsysamples.

However, pathological conditions frequently occur in which the number ofsamples taken has to be greater, as with gastric ulcers, or dysplasia orneoplasia in ulcerative pancolitis, which is a serious chronic diseaseof the colon.

In these cases, each time the space inside the half-shells is filledwith biopsy samples, the forceps has to be withdrawn through theendoscope duct, emptied and reintroduced to the operation site. A largeamount of wear and deformation of the duct thus takes place, with therisk of rupture and consequent infiltration of liquid which may causevery serious damage to the endoscope.

Another problem connected with the need to perform a plurality ofintroductions and withdrawals of the forceps consists of the longduration of this procedure which is due, among other things, to the needto empty the half-shells. Owing to the small size of the samples taken,this operation in fact takes the operator a considerable amount of time.In operative practice, however, the time available—in certainconditions, for example, with markedly intolerant patients who areunable to take sedatives—may be limited, so that the use of conventionalforceps is difficult.

To prevent the problems of the prior art mentioned above, the subject ofthe present invention is forceps of the type described at the beginningof the present description and characterized in that it has at least onecontainer element having a cavity for receiving a plurality of biopsysamples.

The forceps of the invention can therefore be used to take all ofsamples necessary for a given pathological condition, in succession, byperforming only one introduction and withdrawal, thus considerablyreducing the time required for the operation, as well as the wear of theendoscope duct.

Moreover, during the withdrawal stage, the container element keeps thebiopsy samples isolated from the duct, which has the advantage ofpreventing any mixing with impurities or with any scraps remaining fromother samples taken, which may be present therein.

Further advantages and characteristics of the present description,provided by way of non-limiting example with reference to the appendeddrawings, in which:

FIG. 1 is a schematic plan view of a forceps of the invention,

FIG. 2 is a front elevational view of the forceps of FIG. 1,

FIG. 3 is a section view taken on the line III—III of FIG. 1,

FIGS. 4 and 5 are respective plan views of each of the two half-shellsof a forceps constituting an alternative embodiment of the invention,

FIG. 6 is a section taken on the line VI—VI of FIG. 4,

FIG. 7 is a section view taken on the line VII—VII of FIG. 5, and

FIGS. 8 and 9 are views corresponding to FIGS. 5 and 7, respectively, ofa further embodiment of a detail of a forceps of the invention.

A biopsy forceps, for example, for endoscopic biopsy, comprises (FIGS.1–3) two half-shells 10 a, 10 b each having a front rim 12 and a basewall 14. The half-shells 10 a, 10 b are mounted in conventional manner,for example, on a support element 16 so that they can adopt a first,opened-out configuration (shown in the drawings) and a second, closedconfiguration in which the rims 12 of the two half-shells 10 a, 10 b arein contact with one another.

The half-shell lob has, in its base wall 14, a hole 18 whichcommunicates with the cavity 20 inside a beaker-shaped container element22 associated therewith and having a plurality of through-openings 24 inits walls.

The material constituting the element 22 is not critical within thescope of the present invention and may be selected, without particularlimitations, from those suitable for use in the medical field.

The half-shell 10 a, on the other hand, is filled up to approximately athird of its height with filling material 25.

In use, the forceps is first of all passed through an endoscope duct(not shown in the drawings), with the half-shells 10 a, 10 b in theclosed configuration, until the forceps is in the desired location closeto the internal mucosa of the organ to be biopsied. Here, thehalf-shells 10 a, 10 b are opened out and closed again several times insuccession so as to cut off a corresponding number of biopsy samples.

As these samples are taken one by one, they are urged towards the baseof the container element 22 by the pressure exerted by the half-shell 10a.

The openings 24 allow air and any organic liquids which remain trappedin the cavity 20 of the element 22 to be discharged, furtherfacilitating the movement of the biopsy samples inside the element 22.

Upon completion of the cutting of the samples, the half-shells 10 a, 10b are closed again and the forceps, with its duct. The biopsy sampleswhich are enclosed inside the cavity 20 do not therefore have anysubstantial contact with the duct, which could constitute a potentialsource of histological contamination.

FIGS. 4 to 7 show an alternative embodiment of the half-shells of abiopsy forceps according to the invention, which half-shells can bemounted on a support element in a manner similar to that described withreference to FIGS. 1–3.

In this embodiment, the half-shell 10 a with which the container element20 is not associated has (FIGS. 4 and 6) a base wall 14 having a centralportion 26 which is raised substantially to the level of the rim 12, andan annular, recessed, peripheral portion 28.

The half-shell 10 b, on the other hand, (FIGS. 5 and 7) has, in its basewall 14, the hole 18 in which the end of the beaker-shaped containerelement 22 is fixed by means of an annular layer of adhesive 30, thisend being open and having a restricted neck. The internal cavity 20 ofthe container element 22 thus constitutes a continuation of the spaceinside the half-shell 10 b.

The container element 22 also has openings 24 in its base and sidewalls.

The principle of the operation of the forceps having the half-shellsjust mentioned is substantially similar to that described with referenceto FIGS. 1–3. The particular shape of the half-shell 10 a enables agreater pressure to be exerted on the biopsy samples, directing themtowards the cavity 20 of the element 22.

FIGS. 8 and 9 show a variant of the fixing of the container element 22to the half-shell 10 b, which is an alternative to the use of theabove-described layer of adhesive. In this case, the open end of theelement 22 has a hooked rim for engaging a rim of complementary shape ofthe hole 18 of the half-shell 10 b. This engagement is preferablysecured by a mechanical element such as a spring ring 32.

Naturally, the principle of the invention remaining the same, thedetails of construction and forms of embodiment may be varied widelywith respect to those described purely by way of example, withoutthereby departing from its scope. In particular, both of the half-shellsmay have their own container elements and/or may have, independently ofone another, any shape, for example, with a toothed or serrated rim. Thecontainer element in turn may have substantially any shape and/or lengthand/or may be in the form of a net engaged directly on the rim of theassociated half-shell. Moreover, the container element may equally wellbe secured on the respective half-shell immovably, or releasably.

1. Forceps for medical use, in particular for biopsy, comprising: afirst and a second half-shell, each having a front rim and a base wall,the first and the second half-shells each being mounted on a supportelement in a manner such that the first and the second half-shells canadopt a first, open configuration and a second, closed configuration;and a container element associated with at least the first half-shell,the container element having a cavity for receiving a plurality ofbiopsy samples, wherein the container element is received in a holedefined by the base wall of the first half-shell, wherein the base wallof the second half-shell includes a central portion raised toward thefront rim of the second half-shell.
 2. Forceps according to claim 1,wherein the central portion is raised substantially to the level of therim, and the base wall of the second half-shell further includes anannular, recessed, peripheral portion.
 3. Forceps according to any oneof the preceding claims, wherein the hole communicates with the cavityof the container element associated with the first half-shell. 4.Forceps according to claim 3, wherein the container element isbeaker-shaped and is fixed in the hole such that the cavity constitutesa continuation of a space inside the first half-shell.
 5. Forcepsaccording to claim 4, wherein the container element includes an open endfixed to the first half-shell by an annular layer of adhesive. 6.Forceps according to claim 4, wherein the container element includes anopen end having a hooked rim for engaging the front rim of the firsthalf-shell.
 7. Forceps according to claim 6, wherein the engagement ofthe hooked rim of the open end of the container element with the frontrim of the hole of the first half-shell is secured by a mechanicalelement.
 8. Forceps according to claim 7, wherein the mechanical elementis a spring ring.
 9. Forceps according to claim 6, wherein the front rimof the first half-shell is a complementary shape of the hooked rim ofthe container element.
 10. Forceps according to claim 3, wherein thecontainer element is beaker-shaped and includes a container base andside walls, and has at least one opening in the container base or in theside walls.
 11. Forceps according to claim 1, wherein the containerelement is beaker-shaped and includes a container base and side walls,and has at least one opening in the container base or in the side walls.12. Forceps according to claim 11, wherein the container element has aplurality of openings in the container base and in the side walls. 13.Forceps according to claim 1, wherein at least a portion of thecontainer element is completely encircled by the base wall.
 14. Forcepsaccording to claim 1, wherein the hole is configured to pass theplurality of biopsy samples therethrough.
 15. A biopsy forceps,comprising: a support element; a first half-shell supported by thesupport element, the first half-shell having a first front rim and abase wall; a second half-shell supported by the support element, thesecond half-shell having a second front rim, the first and the secondhalf-shells being operatively configured to open and close to takebiopsy samples; and a container element affixed to the first half-shell,the container element having a first opening to a cavity for receivingthe biopsy samples, and a second opening for discharging fluid from thecavity, wherein the container element is received in a hole defined bythe base wall of the first half-shell, wherein a base wall of the secondhalf-shell includes a central portion raised toward the front rim of thesecond half-shell.
 16. A biopsy forceps according to claim 15, whereinthe central portion is raised substantially to the level of the rim, andthe base wall of the second half-shell further includes an annular,recessed, peripheral portion.
 17. A biopsy forceps according to claim15, wherein the first half-shell includes a hole which communicates withthe first opening to the cavity of the container element affixed to thefirst half-shell.
 18. A biopsy forceps according to claim 17, whereinthe container element is beaker-shaped and the cavity is incommunication with a space inside the first half shell.
 19. Forcepsaccording to claim 15, wherein at least a portion of the containerelement is completely encircled by the base wall.
 20. Forceps accordingto claim 15, wherein the hole is configured to pass the biopsy samplestherethrough.
 21. Forceps for medical use, in particular for biopsy,comprising: a first and a second half-shell, each having a front rim anda base wall, the first and the second half-shells each being mounted ona support element in a manner such that the first and the secondhalf-shells can adopt a first, open configuration and a second, closedconfiguration, the first and second half-shells being configured so thatthe front rims come into contact with each other when in the closedconfiguration; and a container element associated with at least thefirst half-shell, the container element having a cavity for receiving aplurality of biopsy samples, wherein the base wall of the secondhalf-shell includes a central portion raised toward the front rim of thesecond half-shell, wherein the base wall of the first half-shellincludes a hole in which the container element is received.
 22. Forcepsaccording to claim 21, wherein the container element is beaker-shapedand includes a container base and side walls, and has at least oneopening in the container base or in the side walls.
 23. Forcepsaccording to claim 21, wherein the hole communicates with the cavity ofthe container element associated with the first half-shell.
 24. Forcepsaccording to claim 21, wherein the container element is fixed in thehole such that the cavity constitutes a continuation of a space insidethe first half-shell.
 25. Forceps according to claim 21, wherein thecentral portion is raised substantially to the level of the rim, and thebase wall of the second half-shell further includes an annular,recessed, peripheral portion.
 26. Forceps according to claim 21, whereinthe container element has a plurality of openings in the container baseand in the side walls.
 27. Forceps according to claim 21, wherein atleast a portion of the container element is completely encircled by thebase wall.
 28. Forceps according to claim 21, wherein the hole isconfigured to pass the plurality of biopsy samples therethrough. 29.Forceps for medical use, in particular for biopsy, comprising: a firstand a second half-shell, each having a front rim and a base wall, thefirst and the second half-shells each being mounted on a support elementin a manner such that the first and the second half-shells can adopt afirst, open configuration and a second, closed configuration, whereinthe first half-shell includes a hole in the base wall configured to passa biopsy sample; and a container element associated with the firsthalf-shell, the container element having an open end for receiving thebiopsy sample into a cavity sized to contain a plurality of biopsysamples, the open end corresponding in size to the hole in the base wallof the first half-shell, wherein the base wall of the second half-shellincludes a central portion raised toward the front rim of the secondhalf-shell.
 30. Forceps according to claim 29, wherein the centralportion is raised substantially to the level of the rim, and the basewall of the second half-shell further includes an annular, recessed,peripheral portion.
 31. Forceps according to claim 29, wherein thecontainer element is beaker-shaped and is fixed in the hole such thatthe cavity constitutes a continuation of a space inside the firsthalf-shell.
 32. Forceps according to claim 29, wherein the containerelement includes an open end having a hooked rim for engaging the frontrim of the first half-shell.
 33. Forceps according to claim 32, whereinthe front rim of the first half-shell is a complementary shape of thehooked rim of the container element.
 34. Forceps according to claim 29,wherein the container element is beaker-shaped and includes a containerbase and side walls, and has at least one opening in the container baseor in the side walls.
 35. Forceps according to claim 29, wherein thehole in the base wall of the first half-shell receives the containerelement.
 36. Forceps for medical use, in particular for biopsy,comprising: a first and a second half-shell, each having a front rim anda base wall, the first and the second half-shells each being mounted ona support element in a manner such that the first and the secondhalf-shells can adopt a first, open configuration and a second, closedconfiguration; and a container element associated with at least thefirst half-shell, the container element having a cavity for receiving aplurality of biopsy samples, wherein the container element is receivedin a hole defined by the base wall of the first half-shell, wherein thesecond half-shell is not configured to receive a plurality of biopsysamples.
 37. Forceps according to claim 36, wherein the base wall of thesecond half-shell includes a central portion raised substantially to thelevel of the rim, and an annular, recessed, peripheral portion. 38.Forceps according to claim 36, wherein the container element isbeaker-shaped and is fixed in the hole such that the cavity constitutesa continuation of a space inside the first half-shell.
 39. Forcepsaccording to claim 36, wherein the container element includes an openend having a hooked rim for engaging the front rim of the firsthalf-shell.
 40. Forceps according to claim 39, wherein the engagement ofthe hooked rim of the open end of the container element with the frontrim of the hole of the first half-shell is secured by a mechanicalelement.
 41. Forceps according to claim 40, wherein the mechanicalelement is a spring ring.
 42. Forceps according to claim 39, wherein thefront rim of the first half-shell is a complementary shape of the hookedrim of the container element.
 43. Forceps according to claim 36, whereinthe container element includes a container base and side walls, and hasat least one opening in the container base or in the side walls. 44.Forceps according to claim 43, wherein the container element has aplurality of openings in the container base and in the side walls. 45.Forceps according to claim 36, wherein at least a portion of thecontainer element is completely encircled by the base wall.
 46. Forcepsaccording to claim 36, wherein the hole is configured to pass theplurality of biopsy samples therethrough.
 47. A biopsy forceps,comprising: a support element; a first half-shell supported by thesupport element, the first half-shell having a first front rim and abase wall; a second half-shell supported by the support element, thesecond half-shell having a second front rim, the first and the secondhalf-shells being operatively configured to open and close to takebiopsy samples; and a container element affixed to the first half-shell,the container element having a first opening to a cavity for receivingthe biopsy samples, and a second opening for discharging fluid from thecavity, wherein the container element is received in a hole defined bythe base wall of the first half-shell, wherein the second half-shell isnot configured to receive a plurality of biopsy samples.
 48. A biopsyforceps according to claim 47, wherein the second half-shell includes abase wall having a central portion raised substantially to the level ofthe rim, and an annular, recessed, peripheral portion.
 49. A biopsyforceps according to claim 47, wherein the first half-shell includes ahole which communicates with the first opening to the cavity of thecontainer element affixed to the first half-shell.
 50. A biopsy forcepsaccording to claim 47, wherein the cavity of the container element is incommunication with a space inside the first half shell.
 51. Forcepsaccording to claim 47, wherein at least a portion of the containerelement is completely encircled by the base wall.
 52. Forceps accordingto claim 47, wherein the hole is configured to pass the plurality ofbiopsy samples therethrough.
 53. Forceps for medical use, in particularfor biopsy, comprising: a first and a second half-shell, each having afront rim and a base wall, the first and the second half-shells eachbeing mounted on a support element in a manner such that the first andthe second half-shells can adopt a first, open configuration and asecond, closed configuration, the first and second half-shells beingconfigured so that the front rims come into contact with each other whenin the closed configuration; and a container element associated with atleast the first half-shell, the container element having a cavity forreceiving a plurality of biopsy samples, wherein the second half-shellis not configured to receive a plurality of biopsy samples, wherein thebase wall of the first half-shell includes a hole in which the containerelement is received.
 54. Forceps according to claim 53, wherein thecontainer element includes a container base and side walls, and has atleast one opening in the container base or in the side walls. 55.Forceps according to claim 54, wherein the container element has aplurality of openings in the container base and in the side walls. 56.Forceps according to claim 53, wherein the hole communicates with thecavity of the container element associated with the first half-shell.57. Forceps according to claim 53, wherein the container element isfixed in the hole such that the cavity constitutes a continuation of aspace inside the first half-shell.
 58. Forceps according to claim 53,wherein the base wall of the second half-shell includes a centralportion raised substantially to the level of the rim, and an annular,recessed, peripheral portion.
 59. Forceps according to claim 53, whereinat least a portion of the container element is completely encircled bythe base wall.
 60. Forceps according to claim 53, wherein the hole isconfigured to pass the plurality of biopsy samples therethrough. 61.Forceps for medical use, in particular for biopsy, comprising: a firstand a second half-shell, each having a front rim and a base wall, thefirst and the second half-shells each being mounted on a support elementin a manner such that the first and the second half-shells can adopt afirst, open configuration and a second, closed configuration, whereinthe first half-shell includes a hole in the base wall configured to passa biopsy sample; and a container element associated with the firsthalf-shell, the container element having an open end for receiving thebiopsy sample into a cavity sized to contain a plurality of biopsysamples, the open end corresponding in size to the hole in the base wallof the first half-shell, wherein the second half-shell is not configuredto receive a plurality of biopsy samples.
 62. Forceps according to claim61, wherein the base wall of the second half-shell includes a centralportion raised substantially to the level of the rim, and an annular,recessed, peripheral portion.
 63. Forceps according to claim 61, whereinthe container element is fixed in the hole such that the cavityconstitutes a continuation of a space inside the first half-shell. 64.Forceps according to claim 61, wherein the container element includes anopen end having a hooked rim for engaging the front rim of the firsthalf-shell.
 65. Forceps according to claim 64, wherein the front rim ofthe first half-shell is a complementary shape of the hooked rim of thecontainer element.
 66. Forceps according to claim 61, wherein thecontainer element includes a container base and side walls, and has atleast one opening in the container base or in the side walls. 67.Forceps according to claim 61, wherein the hole in the base wall of thefirst half-shell receives the container element.